Dear Doc: Am I lacking male hormones?

Q Doc, could you tell me if you think I am lacking in male hormones? Also, what exactly are 'male hormones' and what do they do?

I am a hard-working 31-year-old businessman and I spend least 100 hours per week in the office! But I am in good health, I think.

Recently, however, my sex life has not been very good. In strict confidence, Doc, I have two girlfriends - one in St Andrew, and the other near Black River. I try to see both of them at least twice a week if possible.

Unfortunately, in the last six months, my erections just haven't seemed to be as stiff as they used to be. Don't get me wrong, Doctor, I have not lost my nature. But I believe I am 'softer' than I used to be. By the way, neither of these women have said anything.

Last week, it suddenly struck me that I might be lacking male hormones. So I went to see a well-known doctor in Kingston and I told him about my fears.

He asked me what I thought were rather strange questions - like 'How often do you shave' and 'Do you get morning stiffness?'

Then he examined me thoroughly, paying particular attention to my testicles and penis - and for some reason, the hair on my chest and back.

Then I asked him if I needed hormone pills or injections. He said he didn't think so. He thought my male hormone levels were perfectly OK.

I asked him if I should have a blood test for hormones and he replied: "Not at the moment. Let's discuss it next time I see you."

But I would like your opinion, Doc. Do you think I am suffering from a lack of hormones? And why did he say that he thought my hormone level was all right?

A The male hormone is testosterone. Men produce them in large quantities from their testicles, and also from their adrenal glands (which are near the kidneys).

What it does is to give men a lot of 'drive'. It also makes them think about women and increases their sexual desire.

Among its other effects, are to make facial hair grow and also hair on the body. That is the reason why the doctor was interested in how often you shave! Men who have to shave at least once for the day are scarcely ever lacking in testosterone.

Similarly, the doctor was checking your body hair and pubic hair. Men who have quite a bit of it are not likely to be testosterone-deficient. Also, the same is true of men who sometimes get morning erections.

Doubtless, at the same time as he was looking at your pubic hair, the doctor was checking the size of your testicles and penis. Men who are deficient in male hormones are likely to have 'small' genitals. They may also speak with a high voice - so he will probably have taken note of the way you talk.

Having done all that, the doctor concluded that you do not have a testosterone deficiency. I am sure he knows what he is talking about!

However, he has offered you the opportunity of a blood test, next time you see him. If you can afford it, why not get it done?

Important note: Try to have the blood taken in the morning. That is because of the fact that testosterone levels vary during the day.

Finally, can I offer you a word of advice? Your 'love life' sounds very exhausting. You are driving great distances across the island in order to try and see two women twice a week!

That would be exhausting for anyone, but you are already an extremely hard-working businessman.

You must wait and see what that doctor says about you, and perhaps what your blood test reveals. But my advice to you is to confine yourself to one partner and to stop all this dashing around the island! You should also cut down on the number of hours which you are working.

If you did all that, then I think your concerns about your erections would vanish.

Q Hi, Doctor. I am a 25-year-old female and, five days ago, I had very vigorous (and prolonged) sex with my fiancé.

After, I noticed that my clitoris was swollen to about the size of the end of my thumb!

I think it is now going down slightly and it is only a little tender. I get the feeling that it is full of blood!

What do you think I should do?

A I am almost certain that you have a condition called 'clitoral haematoma'. The word 'haematoma' means 'a collection of blood' - like a bruise.

This is fairly common after a woman has had prolonged, firm rubbing against her clitoris. The intense friction makes the organ bleed a little bit internally.

Fortunately, in most cases, a clitoral haematoma gradually goes down of its own accord. Occasionally, it bursts, spilling a little blood - and then it gets better.

If the swelling has not gone away in one week, I'd like you to check with a doctor. But my guess is that it will be gone by then. Please, no sex until you are completely better.

Q My wife is a highly sexed woman and she has been watching a lot of porn films on the Internet.

As a result, she has been talking to me about giving her rectal sex. Do you feel, Doc, that I have to do this?

A No, I do not - especially as rectal sex remains against the law in Jamaica - even between husband and wife. If you dislike the idea, then don't do it.

Q A nurse has recommended that, when I have sex, I use the diaphragm. But I cannot work out where I must put it, Doc.

AThe diaphragm is a pretty good 'barrier' method of contraception. But you really need to be fitted with one by a doctor or nurse, because of the fact that women's vaginas are of varying shapes and sizes.

You must put it in so that it covers the cervix whenever you have sex. This means that:

❐ The front end must be 'tucked up' behind the pubic bone;

❐ The back end must be behind the cervix.

But you really do need the nurse or doctor to show you precisely how to position it inside you.

Q A man who I have known for years wants to marry me, but he is homosexual. He says he will change and be a straight husband to me.

But can I believe him, Doc?

A Well, men who are bisexual can sometimes change. But it is rare for a completely gay male to 'switch round' and magically become a heterosexual husband. I really don't think this is going to work.